Terminal disinfection effect of hydrogen peroxide atomization sterilizer in blood centers / 中国输血杂志

【Objective】 To observe the effect of hydrogen peroxide atomization sterilizer using low concentration hydrogen peroxide disinfectant on the environment and object surface of physical examination area (hereinafter referred to as " physical examination area" ) in blood centers, so as to provide a simple method which is safe, efficient, easy to operate, harmless to human body and has no corrosive effect on equipment. 【Methods】 The physical examination area was disinfected with atomized hydrogen peroxide sterilizer, and the difference of colony number between air and surface before and after disinfection was compared to evaluate the disinfection effect. 【Results】 After disinfection, the hydrogen peroxide residue was detected for 25 times at 5 points, and the results were (0.7~1)ppm, with no statistical difference (P>0.05). 25 tests were carried out at 5 points, and the quartile of the test results was (0~2)CFU/ dish, and the qualified rate was 100%. The test results of bacteria before and after disinfection were statistically significant (P<0.05), which met the requirements of Class Ⅱ environment in Hygienic Standard for Hospital Disinfection(GB15982-2012). After disinfection, the quartile of surface colony detection results of workbench, blood donor seat, screen and door handle were (0~24.1)CFU/cm2, (1.6~55.4)CFU/cm2, (0~7.2)CFU/cm2 and (0~4.8)CFU/cm2, with the qualified rate at 80%, 48%, 100% and 100%, respectively, which were in accordance with the requirements of Class Ⅲenvironment in GB15982-2012. The number of colonies after disinfection at the above detection sites decreased significantly compared with that before disinfection (P<0.05). The surface contact plate pressing method and cotton swab smearing method were used to detect the number of colonies on the surface of sterilized work tables and blood donor seats, and the detection rate of the former was higher than that of the latter, with statistical significance (P<0.05). 【Conclusion】 After disinfection by hydrogen peroxide atomization sterilizer, the hydrogen peroxide residue met the requirements specified in the manual. The terminal disinfection effect of air in the physical examination area environment can meet the Class Ⅱ environmental requirements of GB15982-2012. However, the number of microorganisms on object surface after terminal disinfection was significantly lower than that before disinfection.

Application of multidisciplinary team in improving the cleanliness of ob-ject surface frequently touched by doctors and nurses / 中国感染控制杂志

Objective To improve the cleanliness of object surface frequently touched by doctors and nurses through collaboration of multidisciplinary team(MDT). Methods In the fourth quarter of 2015,a baseline survey was performed by healthcare-associated infection(HAI)management professionals in a hospital(baseline survey stage),in the first quarter of 2016,HAI management office combined with medical affairs office and nursing de-partment to carry out collaboration of MDT intervention(intervention stage). The second,third,and fourth quar-ters of 2016 were evaluation stages for efficacy of implementation of intervention measures,cleanliness of frequently touched object surface at different stages was compared.Results In the baseline survey,the qualified rates of fluo-rescent labeling in doctor group and nurse group were 44.25% and 61.61% respectively,after MDT joint interven-tion,the qualified rates of fluorescence labeling in doctor group and nurse group increased to 89.83% and 87.50%respectively,difference was statistically significant(both P<0.05). The incidence of HAI in baseline survey stage was 1.22%,at stage three of post-intervention,incidence of HAI was 1.02%,difference was statistically signifi-cant(P<0.05).Conclusion MDT can effectively integrate hospital management resources,make medical affairs office and nursing department give full play to their respective function,and effectively enhance the cleanliness of frequently touched object surface during medical care.

Disinfection efficacy of slightly acidic hypochlorous water on object surface of hemodialysis room / 中国感染控制杂志

Objective To evaluate disinfection efficacy of slightly acidic hypochlorous water (SAHW) on object surfaces of hemodialysis room. Methods 30 dialysis units in the hemodialysis room were dividea into two groups (trichloroisocyanuric acid group and SAHW group) by random number table method, 15 dialysis units in each group. Trichloroisocyanuric acid group disinfected object surface of each hemodialysis unit with trichloroisocyanuric acid containing 500 mg/L available chlorine, and SAHW group disinfected with SAHW. The colony counts on object surface after 4 hour disinfection were detected, the qualified status and killing of multidrug-resistant organisms (MDROs) between two disinfection methods were compared. Results After bedrails, screens of dialysis machine, and knobs of dialysis machine were disinfected by trichloroisocyanuric acid containing 500 mg/L available chlorine and SAHW respectively, the qualified rates of trichloroisocyanuric acid group were 90.00％, 80.00％, and 90.00％ respectively. SAHW group were 100.00％, 96.67％, and 100. 00％ respectively, difference was not significant between two disinfection methods(both P＞0.05). SAHW disinfection testing showed that the killing rates of SAHW to four MDROs were both 100％. Conclusion Disinfection efficacy of SAHW is the same as that of trichloroisocyanuric acid containing 500 mg/L available chlorine, and has high killing effect on the common MDROs in the hemodialysis room.

Intervention efficacy of compliance to cleaning of frequently touch hospital object surfaces / 中国感染控制杂志

Objective To evaluate the cleanliness of frequently touched object surfaces in a hospital and efficacy of intervention measures.Methods Compliance to cleaning of frequently touched object surfaces before and after intervention was surveyed by fluorescence labeling method,SPSS 17.0 statistical software was used to analyze data.Results Before and after intervention,6 800 items in 400 wards were investigated,compliance rates to cleaning of hospital object surfaces before and after intervention were 14.71％ and 54.76％ respectively(P＜0.001);differences in compliance rates to cleaning of object surfaces in common wards and special wards before and after interven tion were both statistically significant(both P＜0.001);after intervention,compliance rates to cleaning of object surfaces in wards and toilets increased significantly compared with before intervention,which increased by 41.57％ and 33.00 ％ respectively,differences were statistically significant (both P＜0.001);after intervention,compliance rates to cleaning of different object surfaces increased by 21.50％-52.00％ (all P＜0.001).Conclusion Scientific and effective intervention measures can improve the cleaning effectiveness of frequently touched object surfaces,which can improve the environmental quality of hospital.

Quantitative study on high-touched object surface in different special intensive care units / 中国感染控制杂志

Objective To identify the high-touched object surface in different special intensive care units(ICUs) through the observation and statistical analysis on the number of touching with common object surfaces in different ICUs, so as to provide basis for hospital environmental management.Methods Direct observation method was used to observe the daily activities of health care workers, the number of touching with various common object surfaces was recorded, Poisson distribution was adopted to statistically analyze the data.Results The average number of touching from high to low was as follows : medical record folder(n=28.00), chair(n=18.38), emergency rescue cart(treatment cart, n=17.29), bed surface(n=13.90), intravenous infusion line(n=13.76), medical pen(n=13.38), and intravenous transfusion pump(n=11.81), these objects accounted for 64.01% of all surface touching number.Different special ICUs were slightly different, general ICU high-touch object included the first 6 categories;cardiothoracic surgery ICU included the above 7 categories besides keyboard and mouse;internal medicine ICU included the first 6 categories and mobile phone.Conclusion High-touched object surface varied with different special ICUs of the same hospital, hospital should make the corresponding disinfection management measures according to the actual situation of high-touched surface of each department, so as to reduce the incidence of healthcare-associated infection.

Effect of medical hygiene wipes on disinfecting object surface and compliance to use in an intensive care unit / 中国感染控制杂志

Objective To evaluate the effect of medical hygiene wipes on disinfecting object surface and compliance to use in an intensive care unit (ICU).Methods 30 beds in the ICU at a hospital were randomly selected and divided into three groups:A,B and C,each group had 10 beds.Group A were only provided hygiene wipes,group B used towel soaked in chlorine-containing disinfectant (disinfected towel),group C were provided both medical hygiene wipes and disinfected towel for selected use.Compliance to different disinfection methods,and disinfectant efficacy on object surface were compared.Results The rate of compliance to disinfection in group A was higher than group B (78.78% vs 42.12%,χ2 =68.56,P <0.05);except medical disposal trolley and ventilator,compliance to disinfection of the other object surface in group A were all higher than group B (all P <0.05).Except ventilator, adenosis triphosphate (ATP)values before and after disinfection of object surface in group A and B were both significantly different (both P <0.05 ),disinfectant efficacy of group A was superior to group B.Group C used medical hygiene wipes more than disinfected towel ([836 times,91 .57%]vs [77 times,8.43%]).Nurses spent (20.15+ 3.00 )minutes on preparing disinfectant every day,and (15.02 ± 2.00 )minutes on washing used disinfected towel,while hygiene wipes could be used immediately,discarded after use,and was timesaving. Conclusion Use of medical hygiene wipes is convenient,rapid,and without irritating odor,it also improves disinfection effect on object surface and ICU health care workers’compliance to disinfection.

Application of ATP bioluminescence assay in survey of cleanliness of hos-pital environmental object surfaces and health care workers’hands / 中国感染控制杂志

Objective To investigate cleanliness of hospital environmental object surfaces and hands of health care workers(HCWs).Methods The adenosine triphosphate (ATP)bioluminescence assay was used to detect object surfaces and hands of HCWs in a hospital,on-the-spot intervention was conducted.Results The qualified rates of hospital environmental object surfaces and ventilator-relevant object surfaces were 58.14% (200/344)and 69.88%(116/166)respectively,the qualified rate of ventilator tracheal intubation site was low (29.17%);the qualified rate of telephone surfaces was the lowest (27.27%).The qualified rates of ventilator-relevant object surfaces used con-tinuously for ≥48h and <48 h were 56.70%(55/97)and 88.41 %(61/69)respectively,there was significant differ-ence between the two(χ2 =19.26,P <0.01).The qualified rates of HCWs’hands before and after intervention were 34.18% and 85.58% respectively,relative light unit (RLU)values were (1 033.46±106.20)and (80.46±10.68) respectively,the qualified rates and RLU before and after intervention were both significantly different (both P <0.01).Conclusion Contamination of object surfaces and hands’of HCWs in hospital dynamic environment is seri-ous,ATP bioluminescence detection and on-the-spot intervention is helpful for improving cleanliness of hospital en-vironment object surfaces and HCWs’compliance to hand hygiene.

Cleaning quality of frequently touched object surfaces / 中国感染控制杂志

Objective To investigate the cleaning quality of frequently touched object surfaces in a hospital,so as to formulate effective evidence-based intervention measures.Methods Frequently touched object surfaces in common wards,operating rooms,and intensive care unit(ICU)of the hospital between October 2014 and February 2015 were labeled by fluorescent adhesive agents 1 -2 times a week,objects were labeled before patients’discharge and at the end of operation,cleaning quality of frequently touched object surfaces were checked after routine cleaning. Results A total of 2 131 object surfaces were monitored,fluorescent adhesive agents on 1 732 objects were cleared, clearance rate was 81 .3%,hygienic clean was qualified.642,650,and 839 objects surfaces in common wards, operating rooms,and ICU were monitored respectively,the clearance rates were 82.1 %,75.8%,and 84.9%respectively,the clearance rates among three wards were significantly different (χ2 =19.964,P <0.001 ).In com-mon wards,fluorescent clearance rates of call buttons,power switches,and equipments were 51 .3%,55.2%,and 58.5% respectively;in operating room,fluorescent clearance rates of room wall,control panel of anesthesia ma-chine,bed-adjusting device,keyboards,and infusion pumps were 38.6%,48.8%,60.0%,61 .3%,and 68.4%,re-spectively;in ICU,fluorescent clearance rates of equipments was 65.9%,all were unqualified.Conclusion The en-vironmental hygiene quality is generally qualified in this hospital,but the cleaning quality of frequently touched ob-ject surfaces needs to be further improved.

Contamination and homology of carbapenem-resistant Acinetobacter baumannii from hospital environmental object surface / 中国感染控制杂志

Objective To investigate the contamination of carbapenem-resistant Acinetobacter baumannii (CRAB) from object surface of key departments in a hospital,and identify whether these CRAB were homologous. Methods Environmental hygienic monitoring in intensive care unit (ICU),emergency intensive care unit(EICU), hemodialysis room and operating room was conducted.Acinetobacter baumannii (A.baumannii)isolated from ICU and EICU environmental specimens were amplified and typed by enterobacterial repetitive intergenic consensus-poly-merase chain reaction (ERIC-PCR).Results Except hand hygiene of health care workers in EICU was qualified, bacterial count of object surface of ICU and EICU were all unqualified;detection results of specimens from hemodi-alysis room and operating room were all qualified.A total of 53 specimens were taken from object surface of ICU and EICU,7 (13.21 %)A.baumannii isolates were isolated,and all were CRAB isolates,6 of which were of the same genotype and were identical with A.baumannii from patients’sputum.Conclusion CRAB isolated from object surface in key departments is homologous,cleaning and disinfection of environmental object surface should be inten-sified to reduce the occurrence of healthcare-associated infection.

Comparison in disinfection methods and flora detection for object surfaces in laminar flow general intensive care unit / 中国感染控制杂志

Objective To compare the bacteriostasis effect of two disinfectants on frequently touched object sur-faces in laminar flow general intensive care unit (GICU),and investigate bacterial contamination on the object sur-faces,so as to provide reference for proper disinfection method and control of infection.Methods Specimens from surfaces of bed rails and bedside tables were taken for bacterial culture before being disinfected.Then object sur-faces around bed units were disinfected with disinfectant containing 500 mg/L of available chloride (routing group) and GammaTM disinfecting wet wipes (control group)respectively,bacteriostasis rate and qualified rate of bacterial count on object surfaces between two kinds of disinfection methods were compared.Results Before routine disinfec-tion,a total of 87 pathogens were isolated from 200 specimens of object surfaces,bacterial contamination rate was 43.50%. Detection rate of gram-positive bacteria was 78.16%% (n =68),the major were Corynebacterium (26.47%,n = 18), Staphylococcus aureus (23.53%,n=16)and Staphylococcus epidermidis (23.53%,n=16);detection rate of gram-nega-tive bacteria was 21.84%(n=19),the major was Acinetobacter baumannii (63.16%,n=12).After a 10-minute disinfec-tion on surfaces,bacteriostasis rate of routine group and control group was (94.89±7.72)% and(96.33 ±12.88)% re-spectively,there was no significant difference between two groups(P >0.05);qualified rates of bacterial count of object surfaces of two groups were both 100%.Conclusion Regular disinfection of object surfaces around bed units,stand-ardization of the manipulation and hand hygiene compliance of medical personnels are simple and effective method of cutting off bacteria dissemination and preventing healthcare-associated infection.

Observation and comparison on two disinfection methods with medical wiping towel / 中国实用护理杂志

Objective To discuss the disinfection effect of the wiping towel with microwave oven. Methods 200 wiping towels were chosen in class Ⅱ environment in our hospital. 100 wiping towels (the control group)were disinfected by soaking in the chlorine-containing disinfectant,the other (the observation group )by microwave. The disinfection effect, the disinfection time, and the economic cost in three months were compared between two groups. Results There was no significant difference between two groups in the disinfection effect. There was significant difference between two groups in the disinfection time,the economic cost in three months. Conclusions Adopting microwave oven for towel disinfeciton has reliable result and is convenient. It costs shorter time and lower cost. The new method has no chemical side effect and can replace traditional method. It is an ideal disinfection method and worthy of clinical application.